Dr. ANDERSON. The whole problem of reconversion from an emergency to a peacetime operation is seriously handicapped because of the shortage of personnel in the headquarters' office. The provision of personnel in the original 1946 appropriation reached an unprecedented low point in headquarters' staffing. This was brought about by a number of factors associated with the war. We were reduced to operating a program exceeding $20,000,000 with a total of 40 employees, largely at the clerical level. During the war, operations were conducted on a makeshift basis. Additional overtime was necessary beyond the 48-hour week. Field personnel were brought in to augment the staff and a number of very important functions were discontinued that must now be resumed if the job is to be done effectively.

Mr. LUDLOW. What would these eight persons do? What would be their civil-service grade?

Dr. ANDERSON. That is shown on the green sheets. We have requested two-tenths of a man-year for a grade CAF-11. In the clerical, administrative, and fiscal grades, we have provided for two-tenths of a man-year for a grade 11 which salary range is between $4,300 and $5,300; two-tenths of a man-year at grade 9, administrative assistant; three-tenths for a budget analyst in the same grade; and two-tenths for a procedural analyst in the same grade. The rest earn salaries from below $3,000 to $3,700.

Mr. LUDLOW. Just in the lesser employees?

Dr. ANDERSON. Yes.

NEED FOR AN ANALYST

Mr. LUDLOW. Why do you need an analyst?

Dr. ANDERSON. Basically for this reason, sir-that in the general level of qualifications that existed in these 40 employees, it was impossible to carry on an efficient and effective program. In December of 1944, at which time I became associated with this Division, we had on duty in filled positions, 37. All of those positions were below, or I should say, none of those positions were above, the grade CAF-7. The salary range of a CAF-7 is from $2,920 to $3,640. Therefore, I was faced with the problem of operating a rather large appropriation and all the responsibilities in connection with medical care with essentially clerical help. There were two positions above that grade; a CAF-10 and CAF-12.

Mr. LUDLOW. The top man that you take on would be a CAF-12? Dr. ANDERSON. That is correct for fiscal year 1945.

Mr. LUDLOW. Why is he needed?

Dr. ANDERSON. We have found it necessary to establish several sections in the Department set-up to handle items such as equipment and supplies.

Mr. LUDLOW. He would be a specialist, then?

Dr. ANDERSON. That is correct, sir.

Mr. LUDLOW. How many would that give you altogether at the headquarters?

Dr. ANDERSON. The total would be 72.

PERSONNEL CEILING

Mr. LUDLOW. What is your present ceiling?

Dr. ANDERSON. The present ceiling that we are operating under this fiscal year, or this quarter I should say, as allowed by the Bureau of the Budget, is 60. The ceiling of course will be adjusted in accordance with the appropriation.

NUMBER OF VACANCIES

Mr. LUDLOW. Do you have any vacancies now?

Dr. ANDERSON. I have a few in newly created positions recently approved by the Civil Service Commission which cannot be filled until funds become available.

Mr. LUDLOW. Would you take in these eight additional that you estimate for here right away?

Dr. ANDERSON. Yes.

Mr. LUDLOW. Would you stagger them?

Dr. ANDERSON. I would be able to fill these positions within the next month.

Mr. LUDLOW. Well, now, the salary obligation is $22,593 in this estimate. What would be the salary obligation of the eight for the

entire year?

Dr. ANDERSON. Over an entire year that would amount to $108,446. Mr. LUDLOW. For eight employees?

Dr. ANDERSON. No, that is for the 32 employees.

Mr. LUDLOW. I am speaking now of this increase that you estimate here, the eight. What would be the salary obligation over a year? Dr. ANDERSON. The 8 man-years of service, Mr. Chairman, represents 32 positions.

Mr. LUDLOW. Thirty-two employees?

Dr. ANDERSON. That is correct; sir.

Mr. LUDLOW. And spread over a year. That would be over $100,000?

Dr. ANDERSON. That is correct. It would amount to $108,446. Mr. LUDLOW. I notice that you estimate 558.2 man-years of civilian personnel at a cost of $1,178,271, with $160,384 for certain necessary reclassifications.

How many positions would be represented by those man-years? Dr. ANDERSON. The 558.2 man-years is equivalent to 2,013 positions.

Mr. LUDLOW. Why do you need so many positions? You will have a very large salary obligation on that for a year.

Dr. ANDERSON. The salary obligation for the 2,013 positions-I do not have that figure here.

Mr. LUDLOW. You can put that in the record.

Dr. ANDERSON. Yes.

(The information requested is as follows:)

The per annum salary of 2,013 positions representing the 558.2 man-years would be $4,249,121. This does not necessarily represent a full year's obligation since more personnel is required during conversion than after stabilization has been reached. Moreover, this will replace overtime pay of approximately $2,800,000.

Mr. LUDLOW. Why do you need so many additional people in the field?

FIELD PERSONNEL

Dr. ANDERSON. I would like to take up first the field personnel, and I think I can give you a more intelligent and comprehensive

answer.

On the basis of our requirements for a deficiency of $1,178,271 in field-personnel service, we have divided that in this way: For conversion to the 40-hour workweek the amount is $688,756. Our request for overtime under Public Law 106 was for a period of 9 months, and the only amount requested for conversion is for the remaining 3 months of this fiscal year.

Mr. TABER. You mean that this is for additional employees who have been put on since you figured this budget for Public Law 106? Dr. ANDERSON. No; the additional employees are in connection with staffing, which requires additional personnel to come from a 48-hour workweek to a 40-hour workweek.

In the case of institutions you have many positions that must operate for the 24-hour period, such as nurses, attendants, fireroom employees, and kitchen and other positions must be covered. In making this determination, the amount of coverage will vary all the way from zero in some positions in the administration end of hospitals, to 24.6 percent, in positions which must be covered at all times. Our request of $688,756 is for conversion to the 40-hour week, that can be accomplished in fiscal year 1946.

OTHER PERSONNEL

Mr. LUDLOW. What are the other increments of personnel involved here?

Dr. ANDERSON. These are to replace the present personal service heretofore covered by several appropriations other than Public Health Service appropriations, such as the War Shipping Administration, the Coast Guard, and the Red Cross, which provided 906 positions or 440 man-years of service in the past fiscal year, and for the correction of inadequate staffing, $318,158.

During the war, because of the inability to secure personnel, because the labor market was scarce, there was a tremendous amount of work to be done in hospitals with an inadequate staff, and the growth in the volume of the work load necessitated our replacing these voluntary workers to some extent. But our replacement by voluntary service is the equivalent of what we are now asking for. It is also a correction for the attrition that has taken place from one appropriation to another, because of inability to recruit to meet the full need. In other words, from year to year, as we are unable to fill certain positions, we are required to use various types of expedients to accomplish the job, and some of that was done through the assistance given us in voluntary service.

MIAMI RELIEF STATION

We have, as a new addition to our program, an increase in activities at the Miami relief station. We are requesting in 1946 1.5 man-years at a cost of $2,960.

Mr. LUDLOW. How many persons?

Dr. ANDERSON. That is equivalent of eight positions. It will be recalled that a 65-bed marine hospital was operated in Key West, Fla.,

until about February 1943. At that time it was turned over to the Navy, and we have had inadequate facilities to handle our problems in that area.

PHYSICAL MEDICINE AND REHABILITATION PROGRAM

We also have a request for the increased activities in the physical medicine and rehabilitation program to the amount of $5,113. This is to initiate some preliminary work in connection with that program which has been found necessary to introduce as the result of wartime experience in the field of medicine.

Mr. LUDLOW. How much personnel was involved?

Dr. ANDERSON. The personnel on a total year basis would be 14. Mr. LUDLOW. Tell us about the rest.

CARVILLE, LA., LEPROSORIUM

Dr. ANDERSON. We have also in the item for personal services a provision for upgrading of convalescent and part-time employees at Carville, La., Leprosorium, not included in Public Law 106, in the amount of $12,600.

Mr. LUDLOW. How many employees are affected there?

Dr. ANDERSON. That will affect about 112 employees, but they are, of course, on a part-time basis.

That amount has been determined after a very careful survey by members of the personnel section of the Public Health Service.

These positions, insofar as the salary level goes, were established for these part-time employees many years ago.

I am sure we all recognize the difficulty in securing employees to work in a leprosorium, and I have received many communications from interested organizations calling our attention to the need for salary increases, and we have recognized that as a legitimate need.

In addition to that, Executive Order 9655, effective November 14, 1945, provides for salary increases of full-time employees at the Carville Leprosorium which, of course, is mandatory. The request for this item amounts to $101,622.

RECLASSIFICATION OF NURSES, PHYSIOTHERAPISTS, AND DIETITIANS

The last item in personal services refers to the reclassification of nurses, physiotherapists, and dietitians, requiring the amount of $49,062.

Mr. LUDLOW. How many people would that cover?

Dr. ANDERSON. Approximately 1,200 positions.

Mr. LUDLOW. In the estimate for the field service there is an item of $163,284 set up for certain necessary reclassifications. What are those? Would that be for Carville?

Dr. ANDERSON. Yes. That includes nurses, physiotherapists, and dietitians as well as additional money provided for the unclassified employees.

DISABLED VETERANS AND WAR-DISABLED MERCHANT SEAMEN

Mr. LUDLOW. I notice on page 26 of the justifications a statement that many of the beneficiaries of the Public Health Service are dis

abled veterans and war-disabled merchant seamen. Why should that be?

Dr. ANDERSON. We have for many years provided certain bed allocations to the Veterans' Administration. More recently we have received a number of requests from them to give further assistance, and we have increased our bed allocation so that today we have a daily average load of veterans in our hospitals of about 1,004.

Mr. LUDLOW. You referred to a second-class relief station at Miami, Fla. What is the capacity of that station?

Dr. ANDERSON. That provides out-patient dispensary service to all Public Health Service beneficiaries in that area, and in addition to that we will make arrangements for the hospitalization of such beneficiaries.

Mr. LUDLOW. Is that Government-owned?

Dr. ANDERSON. The premises are in the Federal Building, but they are inadequate and we have, through the cooperation of the local city government and the Federal Works Agency, been able to secure space in an addition now made to the Jackson Memorial Hospital. Mr. LUDLOW. Is there any rent charged for that?

Dr. ANDERSON. Yes.

Mr. LUDLOW. How much?

Dr. ANDERSON. It is about $9,600 a year.

Mr. LUDLOW. What expansion of this space is contemplated? Dr. ANDERSON. The only expansion contemplated is to provide for some additional employees and to provide additional facilities which will allow us to put in the equipment necessary to operate, such as a few dental chairs, a laboratory, and medical examining rooms, and we will have this out-patient department located in the Jackson Memorial Hospital for the handling of our out-patients.

Mr. LUDLOW. Is there any authorization pending for the establishment of a marine hospital at Miami?

Dr. ANDERSON. There is not. In our postwar program there is being given consideration to the provision of such a facility somewhere in Florida.

Mr. LUDLOW. You believe your authority is sufficient to enable you to proceed without authorization?

Dr. ANDERSON. You mean the authorization for the out-patient department?

Mr. LUDLOW. For the establishment of a marine hospital at Miami. Dr. ANDERSON. No, sir; we have no authority for that at the present time.

LOCATION OF MARINE HOSPITALS

Mr. LUDLOW. Where are your present permanent marine hospitals located?

Dr. ANDERSON. They are located at various points throughout the United States.

Mr. LUDLOW. You can put a statement about that in the record. Dr. ANDERSON. On the east coast we could start at Boston, and then we have one at Norfolk.

Mr. TABER. Do you not have one at Portland?

Dr. ANDERSON. At Portland, Maine; yes. We also have one at Boston, Mass.; Norfolk, Va.; and at New York we have the Stapleton